[Congressional Record Volume 161, Number 111 (Thursday, July 16, 2015)]
[Senate]
[Pages S5158-S5163]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
OLDER AMERICANS ACT REAUTHORIZATION ACT OF 2015
Ms. COLLINS. Mr. President, I ask unanimous consent that the Senate
now proceed to the consideration of Calendar No. 12, S. 192; that the
bill be read for the third time; and that the Senate vote on passage of
the bill with no intervening action or debate.
The PRESIDING OFFICER. The clerk will report the bill by title.
The bill clerk read as follows:
A bill (S. 192) to reauthorize the Older Americans Act of
1965, and for other purposes.
There being no objection, the Senate proceeded to consider the bill.
The bill was ordered to be engrossed for a third reading and was read
the third time.
The PRESIDING OFFICER. Hearing no further debate, the question is,
Shall the bill pass?
The bill (S. 192) was passed, as follows:
S. 192
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Older Americans Act
Reauthorization Act of 2015''.
SEC. 2. DEFINITIONS.
Section 102 of the Older Americans Act of 1965 (42 U.S.C.
3002) is amended--
(1) by striking paragraph (1) and inserting the following:
``(1) The term `abuse' means the knowing infliction of
physical or psychological harm or the knowing deprivation of
goods or services that are necessary to meet essential needs
or to avoid physical or psychological harm.'';
(2) by striking paragraph (3) and inserting the following:
``(3) The term `adult protective services' means such
services provided to adults as
[[Page S5159]]
the Secretary may specify and includes services such as--
``(A) receiving reports of adult abuse, neglect, or
exploitation;
``(B) investigating the reports described in subparagraph
(A);
``(C) case planning, monitoring, evaluation, and other
casework and services; and
``(D) providing, arranging for, or facilitating the
provision of medical, social service, economic, legal,
housing, law enforcement, or other protective, emergency, or
support services.'';
(3) by striking paragraph (4) and inserting the following:
``(4) The term `Aging and Disability Resource Center' means
an entity, network, or consortium established by a State as
part of the State system of long-term care, to provide a
coordinated and integrated system for older individuals and
individuals with disabilities (as defined in section 3 of the
Americans with Disabilities Act of 1990 (42 U.S.C. 12102)),
and the caregivers of older individuals and individuals with
disabilities, that provides--
``(A) comprehensive information on the full range of
available public and private long-term care programs,
options, service providers, and resources within a community,
including information on the availability of integrated long-
term care services, and Federal or State programs that
provide long-term care services and supports through home and
community-based service programs;
``(B) person-centered counseling to assist individuals in
assessing their existing or anticipated long-term care needs
and goals, and developing and implementing a person-centered
plan for long-term care that is consistent with the desires
of such an individual and designed to meet the individual's
specific needs, goals, and circumstances;
``(C) access for individuals to the full range of publicly-
supported long-term care services and supports for which the
individuals may be eligible, including home and community-
based service options, by serving as a convenient point of
entry for such programs and supports; and
``(D) in cooperation with area agencies on aging, centers
for independent living described in part C of title VII of
the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.), and
other community-based entities, information and referrals
regarding available home and community-based services for
individuals who are at risk for residing in, or who reside
in, institutional settings, so that the individuals have the
choice to remain in or to return to the community.'';
(4) in paragraph (14)(B), by inserting ``oral health,''
after ``bone density,'';
(5) by striking paragraph (17) and inserting the following:
``(17) The term `elder justice' means--
``(A) from a societal perspective, efforts to--
``(i) prevent, detect, treat, intervene in, and prosecute
elder abuse, neglect, and exploitation; and
``(ii) protect older individuals with diminished capacity
while maximizing their autonomy; and
``(B) from an individual perspective, the recognition of an
older individual's rights, including the right to be free of
abuse, neglect, and exploitation.''; and
(6) in paragraph (18)(A), by striking ``term `exploitation'
means'' and inserting ``terms `exploitation' and `financial
exploitation' mean''.
SEC. 3. ADMINISTRATION ON AGING.
(a) Best Practices.--Section 201 of the Older Americans Act
of 1965 (42 U.S.C. 3011) is amended--
(1) in subsection (d)(3)--
(A) in subparagraph (H), by striking ``202(a)(21)'' and
inserting ``202(a)(18)'';
(B) in subparagraph (K), by striking ``and'' at the end;
(C) in subparagraph (L)--
(i) by striking ``Older Americans Act Amendments of 1992''
and inserting ``Older Americans Act Reauthorization Act of
2015''; and
(ii) by striking ``712(h)(4).'' and inserting ``712(h)(5);
and''; and
(D) by adding at the end the following:
``(M) collect and analyze best practices related to
responding to elder abuse, neglect, and exploitation in long-
term care facilities, and publish a report of such best
practices.''; and
(2) in subsection (e)(2), in the matter preceding
subparagraph (A), by inserting ``, and in coordination with
the heads of State adult protective services programs and the
Director of the Office of Long-Term Care Ombudsman Programs''
after ``and services''.
(b) Training.--Section 202 of the Older Americans Act of
1965 (42 U.S.C. 3012) is amended--
(1) in subsection (a)--
(A) in paragraph (5), by inserting ``health and economic''
before ``needs of older individuals'';
(B) in paragraph (7), by inserting ``health and economic''
before ``welfare'';
(C) in paragraph (14), by inserting ``(including the Health
Resources and Services Administration)'' after ``other
agencies'';
(D) in paragraph (27), by striking ``and'' at the end;
(E) in paragraph (28), by striking the period and inserting
a semicolon; and
(F) by adding at the end the following:
``(29) provide information and technical assistance to
States, area agencies on aging, and service providers, in
collaboration with relevant Federal agencies, on providing
efficient, person-centered transportation services, including
across geographic boundaries;
``(30) identify model programs and provide information and
technical assistance to States, area agencies on aging, and
service providers (including providers operating multipurpose
senior centers), to support the modernization of multipurpose
senior centers; and
``(31) provide technical assistance to and share best
practices with States, area agencies on aging, and Aging and
Disability Resource Centers, on how to collaborate and
coordinate services with health care entities, such as
Federally-qualified health centers, as defined in section
1905(l)(2)(B) of the Social Security Act (42 U.S.C.
1396d(l)(2)(B)), in order to improve care coordination for
individuals with multiple chronic illnesses.'';
(2) in subsection (b)--
(A) in paragraph (5)--
(i) in subparagraph (B), by striking ``and'' after the
semicolon;
(ii) in subparagraph (C), by inserting ``and'' after the
semicolon; and
(iii) by adding at the end the following:
``(D) when feasible, developing, in consultation with
States and national organizations, a consumer-friendly tool
to assist older individuals and their families in choosing
home and community-based services, with a particular focus on
ways for consumers to assess how providers protect the
health, safety, welfare, and rights, including the rights
provided under section 314, of older individuals;'';
(B) in paragraph (8)--
(i) in subparagraph (B), by inserting ``to identify and
articulate goals of care and'' after ``individuals'';
(ii) in subparagraph (D)--
(I) by inserting ``respond to or'' before ``plan''; and
(II) by striking ``future long-term care needs; and'' and
inserting ``long-term care needs;'';
(iii) in subparagraph (E), by adding ``and'' at the end;
and
(iv) by adding at the end the following:
``(F) to provide information and referrals regarding
available home and community-based services for individuals
who are at risk for residing in, or who reside in,
institutional settings, so that the individuals have the
choice to remain in or to return to the community;''; and
(3) by adding at the end the following:
``(g) The Assistant Secretary shall, as appropriate, ensure
that programs authorized under this Act include appropriate
training in the prevention of abuse, neglect, and
exploitation and provision of services that address elder
justice and the exploitation of older individuals.''.
(c) Reports.--Section 207(a) of the Older Americans Act of
1965 (42 U.S.C. 3018(a)) is amended--
(1) in paragraph (2), by striking ``202(a)(19)'' and
inserting ``202(a)(16)''; and
(2) in paragraph (4), by striking ``202(a)(17)'' and
inserting ``202(a)(14)''.
(d) Authorization of Appropriations.--Section 216 of the
Older Americans Act of 1965 (42 U.S.C. 3020f) is amended--
(1) in subsection (a), by striking ``2007, 2008, 2009,
2010, and 2011'' and inserting ``2016, 2017, and 2018'';
(2) in subsection (b)--
(A) by striking ``202(a)(24)'' and inserting
``202(a)(21)''; and
(B) by striking ``2007, 2008, 2009, 2010, and 2011'' and
inserting ``2016, 2017, and 2018''; and
(3) in subsection (c), by striking ``2007, 2008, 2009,
2010, and 2011'' and inserting ``2016, 2017, and 2018''.
SEC. 4. STATE AND COMMUNITY PROGRAMS ON AGING.
(a) Authorization of Appropriations.--Section 303 of the
Older Americans Act of 1965 (42 U.S.C. 3023) is amended--
(1) in subsection (a)(1), by striking ``fiscal years 2007''
and all that follows and inserting ``each of fiscal years
2016 through 2018.'';
(2) in subsection (b)--
(A) in paragraph (1), by striking ``fiscal years 2007'' and
all that follows and inserting ``each of fiscal years 2016
through 2018.''; and
(B) in paragraph (2), by striking ``fiscal years 2007'' and
all that follows and inserting ``each of fiscal years 2016
through 2018.'';
(3) in subsection (d), by striking ``fiscal years 2007''
and all that follows and inserting ``each of fiscal years
2016 through 2018.''; and
(4) in subsection (e)(2), by striking ``2011'' and
inserting ``2011 and each of fiscal years 2016 through
2018''.
(b) Allotment.--Section 304 of the Older Americans Act of
1965 (42 U.S.C. 3024) is amended--
(1) in subsection (a)(3), by striking subparagraph (D) and
inserting the following:
``(D)(i) For each of fiscal years 2016 through 2018, no
State shall be allotted an amount that is less than 99
percent of the amount allotted to such State for the previous
fiscal year.
``(ii) For fiscal year 2019 and each subsequent fiscal
year, no State shall be allotted an amount that is less than
100 percent of the amount allotted to such State for fiscal
year 2018.''; and
(2) in subsection (b), by striking ``subpart 1 of''.
(c) Planning and Service Areas.--Section
305(b)(5)(C)(i)(III) of the Older Americans Act of 1965 (42
U.S.C. 3025(b)(5)(C)(i)(III)) is amended by striking
``planning and services areas'' and inserting ``planning and
service areas''.
(d) Area Plans.--Section 306 of the Older Americans Act of
1965 (42 U.S.C. 3026) is amended--
[[Page S5160]]
(1) in subsection (a)--
(A) in paragraph (1), by striking ``establishment,
maintenance, or construction of multipurpose senior
centers,'' and inserting ``establishment, maintenance,
modernization, or construction of multipurpose senior centers
(including a plan to use the skills and services of older
individuals in paid and unpaid work, including
multigenerational and older individual to older individual
work),''; and
(B) in paragraph (6)--
(i) in subparagraph (G), by adding ``and'' at the end; and
(ii) by adding at the end the following:
``(H) in coordination with the State agency and with the
State agency responsible for elder abuse prevention services,
increase public awareness of elder abuse, neglect, and
exploitation, and remove barriers to education, prevention,
investigation, and treatment of elder abuse, neglect, and
exploitation, as appropriate;''; and
(2) in subsection (b)(3)--
(A) in subparagraph (J), by striking ``and'' at the end;
(B) by redesignating subparagraph (K) as subparagraph (L);
and
(C) by inserting after subparagraph (J) the following:
``(K) protection from elder abuse, neglect, and
exploitation; and''.
(e) State Plans.--Section 307(a)(2)(A) of the Older
Americans Act of 1965 (42 U.S.C. 3027(a)(2)(A)) is amended by
striking ``202(a)(29)'' and inserting ``202(a)(26)''.
(f) Nutrition Services Incentive Program.--Section 311(e)
of the Older Americans Act of 1965 (42 U.S.C. 3030a(e)) is
amended by striking ``fiscal year 2007'' and all that follows
and inserting ``each of fiscal years 2016 through 2018.''.
(g) Supportive Services.--Section 321 of the Older
Americans Act of 1965 (42 U.S.C. 3030d) is amended--
(1) in subsection (a)--
(A) in paragraph (1), by striking ``or referral services''
and inserting ``referral, chronic condition self-care
management, or falls prevention services'';
(B) in paragraph (8), by striking ``(including'' and all
that follows and inserting the following: ``(including mental
and behavioral health screening and falls prevention services
screening) to detect or prevent (or both) illnesses and
injuries that occur most frequently in older individuals;''
and
(C) in paragraph (15), by inserting before the semicolon
the following: ``, and screening for elder abuse, neglect,
and exploitation'';
(2) in subsection (b)(1), by inserting ``or modernization''
after ``construction'';
(3) in subsection (c), by inserting before the period the
following: ``, and pursue opportunities for the development
of intergenerational shared site models for programs or
projects, consistent with the purposes of this Act''; and
(4) by adding at the end the following:
``(e) In this section, the term `adult child with a
disability' means a child who--
``(1) is age 18 or older;
``(2) is financially dependent on an older individual who
is a parent of the child; and
``(3) has a disability.''.
(h) Home Delivered Nutrition Services Program.--Section
336(1) of the Older Americans Act of 1965 (42 U.S.C.
3030f(1)) is amended by striking ``canned'' and all that
follows through ``meals'' and inserting ``canned, or fresh
foods and, as appropriate, supplemental foods, and any
additional meals''.
(i) Nutrition Services.--Section 339 of the Older Americans
Act of 1965 (42 U.S.C. 3030g-21) is amended
(1) in paragraph (1), by striking ``solicit'' and inserting
``utilize''; and
(2) in paragraph (2)--
(A) in subparagraph (J), by striking ``and'' at the end;
(B) in subparagraph (K), by striking the period and
inserting ``, and''; and
(C) by adding at the end the following:
``(L) where feasible, encourages the use of locally grown
foods in meal programs and identifies potential partnerships
and contracts with local producers and providers of locally
grown foods.''.
(j) Evidence-Based Disease Prevention and Health Promotion
Services Program.--Part D of title III of the Older Americans
Act of 1965 (42 U.S.C. 3030m et seq.) is amended--
(1) in the part heading, by inserting ``Evidence-Based''
before ``Disease''; and
(2) in section 361(a), by inserting ``evidence-based''
after ``to provide''.
(k) Older Relative Caregivers.--
(1) Technical amendment.--Part E of title III of the Older
Americans Act of 1965 (42 U.S.C. 3030s et seq.) is amended by
striking the subpart heading for subpart 1.
(2) Definitions.--Section 372 of such Act (42 U.S.C. 3030s)
is amended--
(A) in subsection (a)--
(i) in paragraph (1), by striking ``or who is an individual
with a disability''; and
(ii) by striking paragraph (2) and inserting the following:
``(2) Individual with a disability.--The term `individual
with a disability' means an individual with a disability, as
defined in section 3 of the Americans with Disabilities Act
of 1990 (42 U.S.C. 12102), who is not less than age 18 and
not more than age 59.
``(3) Older relative caregiver.--The term `older relative
caregiver' means a caregiver who--
``(A)(i) is age 55 or older; and
``(ii) lives with, is the informal provider of in-home and
community care to, and is the primary caregiver for, a child
or an individual with a disability;
``(B) in the case of a caregiver for a child--
``(i) is the grandparent, stepgrandparent, or other
relative (other than the parent) by blood, marriage, or
adoption, of the child;
``(ii) is the primary caregiver of the child because the
biological or adoptive parents are unable or unwilling to
serve as the primary caregivers of the child; and
``(iii) has a legal relationship to the child, such as
legal custody, adoption, or guardianship, or is raising the
child informally; and
``(C) in the case of a caregiver for an individual with a
disability, is the parent, grandparent, or other relative by
blood, marriage, or adoption, of the individual with a
disability.''; and
(B) in subsection (b)--
(i) by striking ``subpart'' and all that follows through
``family caregivers'' and inserting ``part, for family
caregivers'';
(ii) by striking ``; and'' and inserting a period; and
(iii) by striking paragraph (2).
(l) National Family Caregiver Support Program.--Section 373
of the Older Americans Act of 1965 (42 U.S.C. 3030s-1) is
amended--
(1) in subsection (a)(2), by striking ``grandparents or
older individuals who are relative caregivers.'' and
inserting ``older relative caregivers.'';
(2) in subsection (c)--
(A) in paragraph (1), in the matter preceding subparagraph
(A), by striking ``grandparents and older individuals who are
relative caregivers, and who'' and inserting ``older relative
caregivers, who''; and
(B) in paragraph (2)(B), by striking ``to older individuals
providing care to individuals with severe disabilities,
including children with severe disabilities'' and inserting
``to older relative caregivers of children with severe
disabilities, or individuals with disabilities who have
severe disabilities'';
(3) in subsection (e)(3), by striking ``grandparents or
older individuals who are relative caregivers'' and inserting
``older relative caregivers'';
(4) in subsection (f)(1)(A), by striking ``for fiscal years
2007, 2008, 2009, 2010, and 2011'' and inserting ``for a
fiscal year''; and
(5) in subsection (g)(2)(C), by striking ``grandparents and
older individuals who are relative caregivers of a child who
is not more than 18 years of age'' and inserting ``older
relative caregivers''.
(m) Conforming Amendment.--Part E of title III is amended
by striking ``this subpart'' each place it appears and
inserting ``this part''.
SEC. 5. ACTIVITIES FOR HEALTH, INDEPENDENCE, AND LONGEVITY.
(a) Grant Programs.--Section 411 of the Older Americans Act
of 1965 (42 U.S.C. 3032) is amended--
(1) in subsection (a)--
(A) in paragraph (12), by striking ``and'' at the end;
(B) by redesignating paragraph (13) as paragraph (14); and
(C) by inserting after paragraph (12) the following:
``(13) continuing support for program integrity initiatives
concerning the Medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.) that train
senior volunteers to prevent and identify health care fraud
and abuse; and'';
(2) in subsection (b), by striking ``for fiscal years
2007'' and all that follows through ``2011'' and inserting
``for each of fiscal years 2016 through 2018''.
(b) Native American Programs.--Section 418(b) of the Older
Americans Act of 1965 (42 U.S.C. 3032g(b)) is amended by
striking ``a national meeting to train'' and inserting
``national trainings for''.
(c) Legal Assistance for Older Americans.--Section 420(c)
of the Older Americans Act of 1965 (42 U.S.C. 3032i(c)) is
amended by striking ``national''.
(d) Repeals.--Sections 415, 419, and 421 of the Older
Americans Act of 1965 (42 U.S.C. 3032d, 3032h, 3032j) are
repealed.
(e) Conforming Amendment.--Section 417(a)(1)(A) of the
Older Americans Act of 1965 (42 U.S.C. 3032f(a)(1)(A)) is
amended by striking ``grandparents and other older
individuals who are relative caregivers'' and inserting
``older relative caregivers (as defined in section 372)''.
SEC. 6. COMMUNITY SERVICE SENIOR OPPORTUNITIES.
Section 517(a) of the Older Americans Act of 1965 (42
U.S.C. 3056o(a)) is amended by striking ``fiscal years 2007,
2008, 2009, 2010, and 2011'' and inserting ``each of fiscal
years 2016 through 2018''.
SEC. 7. GRANTS FOR NATIVE AMERICANS.
Section 643(2) of the Older Americans Act of 1965 (42
U.S.C. 3057n(2)) is amended by striking ``fiscal year 2011''
and inserting ``each of fiscal years 2016 through 2018''.
SEC. 8. VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES.
(a) Ombudsman Definitions.--Section 711(6) of the Older
Americans Act of 1965 (42 U.S.C. 3058f(6)) is amended by
striking ``older''.
(b) Ombudsman Programs.--Section 712 of the Older Americans
Act of 1965 (42 U.S.C. 3058g) is amended--
(1) in subsection (a)--
(A) in paragraph (2), by adding at the end the following:
``The Ombudsman shall be responsible for the management,
including the fiscal management, of the Office.'';
(B) in paragraph (3)--
(i) in subparagraph (A), by striking clause (i) and
inserting the following:
[[Page S5161]]
``(i) are made by, or on behalf of, residents, including
residents with limited or no decisionmaking capacity and who
have no known legal representative, and if such a resident is
unable to communicate consent for an Ombudsman to work on a
complaint directly involving the resident, the Ombudsman
shall seek evidence to indicate what outcome the resident
would have communicated (and, in the absence of evidence to
the contrary, shall assume that the resident wishes to have
the resident's health, safety, welfare, and rights protected)
and shall work to accomplish that outcome; and'';
(ii) in subparagraph (D), by striking ``regular and
timely'' and inserting ``regular, timely, private, and
unimpeded'';
(iii) in subparagraph (H)(iii)--
(I) by inserting ``, actively encourage, and assist in''
after ``provide technical support for''; and
(II) by striking ``and'' after the semicolon;
(iv) by redesignating subparagraph (I) as subparagraph (J);
and
(v) by inserting after subparagraph (H) the following:
``(I) when feasible, continue to carry out the functions
described in this section on behalf of residents
transitioning from a long-term care facility to a home care
setting; and'';
(C) in paragraph (5)(B)--
(i) in clause (vi)--
(I) by inserting ``, actively encourage, and assist in''
after ``support''; and
(II) by striking ``and'' after the semicolon;
(ii) by redesignating clause (vii) as clause (viii); and
(iii) by inserting after clause (vi) the following:
``(vii) identify, investigate, and resolve complaints
described in clause (iii) that are made by or on behalf of
residents with limited or no decisionmaking capacity and who
have no known legal representative, and if such a resident is
unable to communicate consent for an Ombudsman to work on a
complaint directly involving the resident, the Ombudsman
shall seek evidence to indicate what outcome the resident
would have communicated (and, in the absence of evidence to
the contrary, shall assume that the resident wishes to have
the resident's health, safety, welfare, and rights protected)
and shall work to accomplish that outcome; and'';
(2) in subsection (b)--
(A) in paragraph (1)--
(i) in subparagraph (A), by striking ``access'' and
inserting ``private and unimpeded access''; and
(ii) in subparagraph (B)--
(I) in clause (i)--
(aa) in the matter preceding subclause (I), by striking
``the medical and social records of a'' and inserting ``all
files, records, and other information concerning a''; and
(bb) in subclause (II), by striking ``to consent'' and
inserting ``to communicate consent''; and
(II) in clause (ii), in the matter before subclause (I), by
striking ``the records'' and inserting ``the files, records,
and information''; and
(B) by adding at the end the following:
``(3) Health oversight agency.--For purposes of section
264(c) of the Health Insurance Portability and Accountability
Act of 1996 (including regulations issued under that section)
(42 U.S.C. 1320d-2 note), the Ombudsman and a representative
of the Office shall be considered a `health oversight
agency,' so that release of residents' individually
identifiable health information to the Ombudsman or
representative is not precluded in cases in which the
requirements of clause (i) or (ii) of paragraph (1)(B), or
the requirements of paragraph (1)(D), are otherwise met.'';
(3) in subsection (c)(2)(D), by striking ``202(a)(21)'' and
inserting ``202(a)(18)'';
(4) in subsection (d)--
(A) in paragraph (1), by striking ``files'' and inserting
``files, records, and other information''; and
(B) in paragraph (2)--
(i) in subparagraph (A)--
(I) by striking ``files and records'' each place such term
appears and inserting ``files, records, and other
information''; and
(II) by striking ``and'' after the semicolon;
(ii) in subparagraph (B)--
(I) by striking ``files or records'' and inserting ``files,
records, or other information''; and
(II) in clause (iii), by striking the period at the end and
inserting ``; and''; and
(iii) by adding at the end the following:
``(C) notwithstanding subparagraph (B), ensure that the
Ombudsman may disclose information as needed in order to best
serve residents with limited or no decisionmaking capacity
who have no known legal representative and are unable to
communicate consent, in order for the Ombudsman to carry out
the functions and duties described in paragraphs (3)(A) and
(5)(B) of subsection (a).''; and
(5) by striking subsection (f) and inserting the following:
``(f) Conflict of Interest.--
``(1) Individual conflict of interest.--The State agency
shall--
``(A) ensure that no individual, or member of the immediate
family of an individual, involved in the designation of the
Ombudsman (whether by appointment or otherwise) or the
designation of an entity designated under subsection (a)(5),
is subject to a conflict of interest;
``(B) ensure that no officer or employee of the Office,
representative of a local Ombudsman entity, or member of the
immediate family of the officer, employee, or representative,
is subject to a conflict of interest; and
``(C) ensure that the Ombudsman--
``(i) does not have a direct involvement in the licensing
or certification of a long-term care facility or of a
provider of a long-term care service;
``(ii) does not have an ownership or investment interest
(represented by equity, debt, or other financial
relationship) in a long-term care facility or a long-term
care service;
``(iii) is not employed by, or participating in the
management of, a long-term care facility or a related
organization, and has not been employed by such a facility or
organization within 1 year before the date of the
determination involved;
``(iv) does not receive, or have the right to receive,
directly or indirectly, remuneration (in cash or in kind)
under a compensation arrangement with an owner or operator of
a long-term care facility;
``(v) does not have management responsibility for, or
operate under the supervision of an individual with
management responsibility for, adult protective services; and
``(vi) does not serve as a guardian or in another fiduciary
capacity for residents of long-term care facilities in an
official capacity (as opposed to serving as a guardian or
fiduciary for a family member, in a personal capacity).
``(2) Organizational conflict of interest.--
``(A) In general.--The State agency shall comply with
subparagraph (B)(i) in a case in which the Office poses an
organizational conflict of interest, including a situation in
which the Office is placed in an organization that--
``(i) is responsible for licensing, certifying, or
surveying long-term care services in the State;
``(ii) is an association (or an affiliate of such an
association) of long-term care facilities, or of any other
residential facilities for older individuals;
``(iii) provides long-term care services, including
programs carried out under a Medicaid waiver approved under
section 1115 of the Social Security Act (42 U.S.C. 1315) or
under subsection (b) or (c) of section 1915 of the Social
Security Act (42 U.S.C. 1396n), or under a Medicaid State
plan amendment under subsection (i), (j), or (k) of section
1915 of the Social Security Act (42 U.S.C. 1396n);
``(iv) provides long-term care case management;
``(v) sets rates for long-term care services;
``(vi) provides adult protective services;
``(vii) is responsible for eligibility determinations for
the Medicaid program carried out under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.);
``(viii) conducts preadmission screening for placements in
facilities described in clause (ii); or
``(ix) makes decisions regarding admission or discharge of
individuals to or from such facilities.
``(B) Identifying, removing, and remedying organizational
conflict.--
``(i) In general.--The State agency may not operate the
Office or carry out the program, directly, or by contract or
other arrangement with any public agency or nonprofit private
organization, in a case in which there is an organizational
conflict of interest (within the meaning of subparagraph (A))
unless such conflict of interest has been--
``(I) identified by the State agency;
``(II) disclosed by the State agency to the Assistant
Secretary in writing; and
``(III) remedied in accordance with this subparagraph.
``(ii) Action by assistant secretary.--In a case in which a
potential or actual organizational conflict of interest
(within the meaning of subparagraph (A)) involving the Office
is disclosed or reported to the Assistant Secretary by any
person or entity, the Assistant Secretary shall require that
the State agency, in accordance with the policies and
procedures established by the State agency under subsection
(a)(5)(D)(iii)--
``(I) remove the conflict; or
``(II) submit, and obtain the approval of the Assistant
Secretary for, an adequate remedial plan that indicates how
the Ombudsman will be unencumbered in fulfilling all of the
functions specified in subsection (a)(3).''; and
(6) in subsection (h)--
(A) in paragraph (3)(A)(i), by striking ``older'';
(B) in paragraph (4), by striking all that precedes
``procedures'' and inserting the following:
``(4) strengthen and update'';
(C) by redesignating paragraphs (4) through (9) as
paragraphs (5) through (10), respectively;
(D) by inserting after paragraph (3) the following:
``(4) ensure that the Ombudsman or a designee participates
in training provided by the National Ombudsman Resource
Center established in section 202(a)(18);'';
(E) in paragraph (6)(A), as redesignated by subparagraph
(C) of this paragraph, by striking ``paragraph (4)'' and
inserting ``paragraph (5)'';
(F) in paragraph (7)(A), as redesignated by subparagraph
(C) of this paragraph, by striking ``subtitle C of the'' and
inserting ``subtitle C of title I of the''; and
(G) in paragraph (10), as redesignated by subparagraph (C)
of this paragraph, by striking ``(6), or (7)'' and inserting
``(7), or (8)''.
[[Page S5162]]
(c) Ombudsman Regulations.--Section 713 of the Older
Americans Act of 1965 (42 U.S.C. 3058h) is amended--
(1) in paragraph (1), by striking ``paragraphs (1) and (2)
of section 712(f)'' and inserting ``subparagraphs (A) and (B)
of section 712(f)(1)''; and
(2) in paragraph (2), by striking ``subparagraphs (A)
through (D) of section 712(f)(3)'' and inserting ``clauses
(i) through (vi) of section 712(f)(1)(C)''.
(d) Prevention of Elder Abuse, Neglect, and Exploitation.--
Section 721 of the Older Americans Act of 1965 (42 U.S.C.
3058i) is amended--
(1) in subsection (b)--
(A) in the matter preceding paragraph (1), by striking
``(including financial exploitation)'';
(B) by redesignating paragraphs (5) through (12) as
paragraphs (6) through (13), respectively;
(C) by inserting after paragraph (4) the following:
``(5) promoting the submission of data on elder abuse,
neglect, and exploitation for the appropriate database of the
Administration or another database specified by the Assistant
Secretary;'';
(D) in paragraph (10)(C), as redesignated by subparagraph
(B) of this paragraph--
(i) in clause (ii), by inserting ``, such as forensic
specialists,'' after ``such personnel''; and
(ii) in clause (v), by inserting before the comma the
following: ``, including programs and arrangements that
protect against financial exploitation''; and
(E) in paragraph (12), as redesignated by subparagraph (B)
of this paragraph--
(i) in subparagraph (D), by striking ``and'' at the end;
and
(ii) by adding at the end the following:
``(F) supporting and studying innovative practices in
communities to develop partnerships across disciplines for
the prevention, investigation, and prosecution of abuse,
neglect, and exploitation; and''; and
(2) in subsection (e)(2), in the matter preceding
subparagraph (A)--
(A) by striking ``subsection (b)(9)(B)(i)'' and inserting
``subsection (b)(10)(B)(i)''; and
(B) by striking ``subsection (b)(9)(B)(ii)'' and inserting
``subsection (b)(10)(B)(ii)''.
SEC. 9. BEHAVIORAL HEALTH.
The Older Americans Act of 1965 is amended--
(1) in section 102 (42 U.S.C. 3002)--
(A) in paragraph (14)(G), by inserting ``and behavioral''
after ``mental'';
(B) in paragraph (36), by inserting ``and behavioral''
after ``mental''; and
(C) in paragraph (47)(B), by inserting ``and behavioral''
after ``mental'';
(2) in section 201(f)(1) (42 U.S.C. 3011(f)(1)), by
inserting ``and behavioral'' after ``mental'';
(3) in section 202(a)(5) (42 U.S.C. 3012(a)(5)), by
inserting ``and behavioral'' after ``mental'';
(4) in section 306(a) (42 U.S.C. 3026(a))--
(A) in paragraph (2)(A), by inserting ``and behavioral''
after ``mental''; and
(B) in paragraph (6)(F), by striking ``mental health
services'' each place such term appears and inserting
``mental and behavioral health services''; and
(5) in section 321(a) (42 U.S.C. 3030d)--
(A) in paragraph (1), as amended by section 4(g), by
inserting ``and behavioral'' after ``mental'';
(B) in paragraph (14)(B), by inserting ``and behavioral''
after ``mental''; and
(C) in paragraph (23), by inserting ``and behavioral''
after ``mental''.
SEC. 10. GUIDANCE ON SERVING HOLOCAUST SURVIVORS.
(a) In General.--Because the services under the Older
Americans Act of 1965 (42 U.S.C. 3001 et seq.) are critical
to meeting the urgent needs of Holocaust survivors to age in
place with dignity, comfort, security, and quality of life,
the Assistant Secretary for Aging shall issue guidance to
States, that shall be applicable to States, area agencies on
aging, and providers of services for older individuals, with
respect to serving Holocaust survivors, including guidance on
promising practices for conducting outreach to that
population. In developing the guidance, the Assistant
Secretary for Aging shall consult with experts and
organizations serving Holocaust survivors, and shall take
into account the possibility that the needs of Holocaust
survivors may differ based on geography.
(b) Contents.--The guidance shall include the following:
(1) How nutrition service providers may meet the special
health-related or other dietary needs of participants in
programs under the Older Americans Act of 1965, including
needs based on religious, cultural, or ethnic requirements.
(2) How transportation service providers may address the
urgent transportation needs of Holocaust survivors.
(3) How State long-term care ombudsmen may address the
unique needs of residents of long-term care facilities for
whom institutional settings may produce sights, sounds,
smells, emotions, and routines, that can induce panic,
anxiety, and retraumatization as a result of experiences from
the Holocaust.
(4) How supportive services providers may consider the
unique needs of Holocaust survivors.
(5) How other services provided under that Act, as
determined by the Assistant Secretary for Aging, may serve
Holocaust survivors.
(c) Date of Issuance.--The guidance described in subsection
(a) shall be issued not later than 180 days after the date of
enactment of this Act.
Ms. COLLINS. Mr. President, I ask unanimous consent that the motion
to reconsider be made and laid upon the table.
The PRESIDING OFFICER. Without objection, it is so ordered.
Ms. COLLINS. Mr. President, the Senate has now passed the
reauthorization of the Older Americans Act by voice vote.
As the chairman of the Senate Committee on Aging and as a Senator who
represents a State with the highest median age, I am well aware of how
important the programs authorized by this law are to our Nation's
seniors. They include, for example, Meals on Wheels, which is a
wonderful program that allows so many of our seniors to stay in their
own homes and yet have their nutritional needs met. I also know how
much the seniors in my State look forward to the visits from those who
are delivering Meals on Wheels. It is a way that their health and well-
being can be checked on. In some cases, it may be the only social
interaction they have on a given day.
In my State, the five area agencies on aging are very active in
delivering the services needed for the seniors in that particular
community or region in my State, particularly in rural Maine, where
there may be an absence of services, such as caregiving services. The
area agency on aging plays an absolutely critical role. In some other
areas of the State, under the Older Americans Act programs,
transportation services are provided to our seniors, legal services,
whatever is needed.
One of the provisions of this bill in which I have a particular
interest is the strengthening of the role of the ombudsman for long-
term care. That is important for the quality of care our seniors are
receiving in nursing homes and other institutionalized settings. But
the great thing about the Older Americans Act is that it helps many of
our seniors avoid nursing homes and instead remain in the comfort,
security, and privacy of their own homes--just where they want to be.
This bill also takes steps to help safeguard older Americans from
abuse and financial exploitation. I know from the hearings we have held
before the Aging Committee that this is a growing problem. In fact, in
the year 2011, it is estimated that older Americans lost some $2.9
billion due to schemes that were foisted on them. That probably is a
greatly understated number because, sadly, 90 percent of this
exploitation comes from people the senior knows well--either a
relative, a trusted adviser, or a caregiver. Oftentimes, seniors are
very hesitant to report these crimes because they don't want to get a
loved one in trouble or they are simply too embarrassed to go to the
police.
We have held hearings on how technology has made the Do Not Call list
virtually useless these days because unfortunately technology allows
people from call centers in India, for example, to call into this
country pretending to be a member of the Internal Revenue Service or
the local police department. Well, when a senior sees on the caller ID
that the Department of Treasury from Washington, DC, is calling, they
are going to pick up the phone, and thus the exploitation begins.
We are making a real effort on the Aging Committee to educate seniors
about these con artists and the techniques they use to try to rip off
people of all ages but with a particular focus on our senior citizens.
So I am pleased that the Older Americans Act is focused on financial
exploitation and trying to stop that kind of abuse.
In short, the reauthorization of these important programs under the
Older Americans Act is long overdue. While we have continued to fund
them, the reauthorization expired years ago, and I am very pleased that
the chairman and the ranking member of the Senate Health, Education,
Labor and Pensions Committee, of which the Presiding Officer is such a
valuable member, have worked together to produce the bipartisan bill we
just passed. This shows what the Senate can do when we work together to
meet the needs of our citizens.
It is an honor to be on the floor to manage this bill. I hope, since
it was 50 years ago this month when the Older
[[Page S5163]]
Americans Act first passed, that we can move rapidly to see it approved
by the House of Representatives as well and signed into law by the
President.
Thank you, Mr. President.
I yield the floor.
Mrs. MURRAY. Mr. President, 50 years ago this week, President Lyndon
Johnson signed the Older Americans Act, which enshrined into law our
responsibility for helping seniors live healthier, fuller, and more
independent lives. Fifty years later, I am pleased Congress has worked
to reauthorize the Older Americans Act to once again uphold that
promise of our Nation. And I am pleased we came together in a
bipartisan way to provide important support for seniors in my home
State of Washington and those across the country.
I especially thank Senators Alexander, Sanders, and Burr for all of
their hard work on this bill. I believe we should be doing everything
we can to support seniors so they can lead healthy, independent lives.
Improving opportunities for seniors is part of how we can restore some
much-needed economic security for them. And it is how we can help
ensure our country is working for all Americans, not just the
wealthiest few.
But today, far too many seniors find themselves skipping meals or
going hungry, instead of getting the nutrition they need. In fact, 9.3
million seniors in our country face the threat of hunger, according to
a 2012 report. And in my home State of Washington, 13.5 percent of
seniors struggle with hunger.
As if that isn't enough, many seniors face other serious challenges,
like elder abuse. That can include mistreatment in a nursing home or
financial exploitation. This bill to reauthorize the Older Americans
Act supports crucial social services and nutrition programs for
seniors.
As one example, this bill sustains our investment in Meals on Wheels.
In my home State of Washington, more than 460,000 seniors enroll in
that program. Meals on Wheels is a critical lifeline for them. It is an
important investment for our country. For every dollar we invest in
Meals on Wheels, we can save up to $50 in Medicaid spending, according
to a study from the Center for Effective Government. Among other
important provisions, the bill also strengthens programs to combat
elder abuse.
This bill focuses on the critical importance of both abuse screenings
and prevention efforts, and it would improve the response to abuse,
neglect, and exploitation in long-term care facilities. It also puts a
key emphasis on evidence-based public health programs.
It bolsters transportation programs, and it ensures that OAA programs
include a focus on seniors' behavioral health needs. I am proud that
this bill is the result of strong bipartisan work. It proves yet again
that when Republicans and Democrats work together, we can get results,
so I hope we can build on this progress.
I want to continue to work with Republicans to find common ground and
get results for families and communities in Washington State and across
the country. And I hope to continue to work on ways to restore economic
stability and security to more seniors.
In 1965, at the original signing of the Older Americans Act,
President Johnson said the true significance of this bill would be in
its results. He said he hoped the bill would, quote, ``help us to
expand our opportunities for enriching the lives of all of our citizens
in our country, now and in the years to come.''
Reauthorizing this law will carry out that mission and expand
opportunities so more seniors can lead healthy, independent lives. It
is an important part of our work to help the economy grow from the
middle out, not the top down. It will be another step toward making
sure our government is working for all families, not just the
wealthiest few.
Today, I call on all my colleagues to support this bill. Let's
reauthorize the Older Americans Act and live up to our Nation's
responsibility to seniors across the country.
Mr. LEAHY. Mr. President, I am glad the Senate has turned today to
the reauthorization of the programs under the Older Americans Act. For
decades, this law has provided community assistance to seniors in
underserved and rural areas across the country, but unfortunately,
these programs have gone unauthorized since 2011. As our population
ages, seniors face an increased need for community resources, which is
what makes this bill so important.
The Older Americans Reauthorization Act of 2015 will prioritize
funding for crucial community and in-home services that offer the
protection and reassurance for seniors requiring specialized care. The
bill will reauthorize transportation assistance and home-delivered
nutrition programs. It will also strengthen State grants for in-home
caregiver support. Through the coordination of community and health
care providers, the bill will improve disease promotion services and
increase mental health awareness among elderly populations.
Furthermore, the legislation will strengthen programs that prevent
senior abuse, neglect, and exploitation by holding health facilities
and adult care homes accountable for promoting excellent patient care.
These programs have given seniors in Vermont and across the country
the chance for independence and wellbeing long after retirement. This
is not a partisan issue, but one we can all agree requires our
dedication and support. I am pleased to cosponsor this legislation and
wish to thank Senators Murray, Alexander, Sanders, and Burr for making
this issue a priority this Congress. I am pleased the Senate has passed
this legislation, which will help to improve the livelihood of our
Nation's seniors.
The PRESIDING OFFICER. The Senator from North Dakota.
Ms. HEITKAMP. Mr. President, once again I see my good friend Senator
Collins fighting for all of the good people of her State and all of our
States and raising important issues--issues that I dealt with, quite
honestly, quite a bit when I was attorney general of my State.
Exploitation is a horrible practice that takes away the dignity and the
opportunity for a healthy life of an elderly American citizen. So I
congratulate the Senator from Maine on her fine work, and I pledge my
full support as she moves forward with this bill.
I thank the Senator from Maine.
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